Speaking at a King’s Fund event on commissioning, the think tank’s deputy director of policy Candace Imison raised concerns about how GP providers and commissioners would interact.

‘The providing side of general practice is going to need its own management structure to enable it to interact in a professional way with the commissioning side,’ she said.

‘But all of this is quite a significant bureaucracy, and it is one that requires people who feel comfortable with business cases and responding to tenders. I think this presents significant challenges to the providing side of general practice.’

King’s Fund chief executive Professor Chris Ham said ‘proper oversight and scrutiny’ would be vital. But he added: ‘I just hope that when the detail is put in there it doesn’t tie up GP commissioners in a lot of red tape that will inhibit innovation.’

Ms Imison also warned of ‘muddy waters’ around plans set out in the White Paper Liberating the NHS.

Dr Imison said there were fundamental issues around ‘how we are going to unleash the energy and enthusiasm that primary care has to redesign services through a more formal commissioning and providing structure’.